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World J Gastroenterol. Nov 7, 2010; 16(41): 5173-5180
Published online Nov 7, 2010. doi: 10.3748/wjg.v16.i41.5173
Transient elastography in chronic hepatitis B: An Asian perspective
Seung Up Kim, Kwang-Hyub Han, Sang Hoon Ahn
Seung Up Kim, Kwang-Hyub Han, Sang Hoon Ahn, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul 120-752, South Korea
Kwang-Hyub Han, Sang Hoon Ahn, Liver Cirrhosis Clinical Research Center, Seoul 120-752, South Korea
Kwang-Hyub Han, Sang Hoon Ahn, Brain Korea 21 Project for Medical Science, Seoul 120-752, South Korea
Author contributions: Kim SU analyzed the data and wrote the paper; Han KH assisted in paper preparation; Ahn SH had the original idea of this paper.
Supported by A Grant from the Good Health R&D Project from the Ministry of Health, Welfare and Family Affairs, Republic of Korea (A050021)
Correspondence to: Sang Hoon Ahn, MD, PhD, Professor, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, 250 Seongsanno, Sodaemun-gu, Seoul 120-752, South Korea.
Telephone: +82-2-22281936 Fax: +82-2-3936884
Received: March 7, 2010
Revised: April 19, 2010
Accepted: April 26, 2010
Published online: November 7, 2010

Transient elastography (TE) is a new non-invasive tool for assessing liver stiffness, which is correlated with the histologic stage of liver fibrosis. Many studies have reported a good accuracy of TE in predicting significant fibrosis and an optimal accuracy in predicting cirrhosis. Furthermore, the potential role of TE in screening the general population has also been proven. TE thus helps physicians to decide treatment strategies, predict prognosis, and monitor disease progression in patients with chronic liver disease and to screen the general population to identify high risk patients with potential liver disease. However, most data on the clinical roles of TE have been gathered in European patients with chronic hepatitis C (CHC), because TE was first developed in France. Accordingly, much data on the usefulness of TE in patients with CHC has accumulated. Recently, however, vigorous efforts have been made to apply TE to patients with chronic hepatitis B (CHB), and TE has also proved to have acceptable accuracy in diagnosing liver fibrosis and cirrhosis in these patients. Thus, we focused on TE in the Asian population with CHB in comparison with the European population with CHC and found that the diagnostic performance and cutoff values were different between the 2 populations possibly as a result of several different confounders between Asian and European populations (the etiology of chronic liver disease, histologic features, major fluctuation in alanine aminotransferase levels, and the prevalence of high body mass index and metabolic syndrome). Therefore, further studies tailored to the Asian population with CHB should be performed before the widespread application of TE in Asian populations with CHB.

Keywords: Asia, Chronic hepatitis B, Fibroscan, Hepatitis B virus, Liver stiffness measurement, Transient elastography